The Departments of Health, Ayush, Health Research, and AIDS Control, under the Health Ministry, have posted a satisfactory performances in utilising the funds during the first three years of the current Five Year Plan, though the States made less encouraging performance, according to the mid-term appraisal by the Planning Commission.

The Gross Budgetary Support (GBS) envisaged for the Eleventh Plan for Department of H&FW and Ayush was Rs.1,36,147 crore and Rs.3,988 crore respectively, making a total of Rs.1,40,135 crore for the Ministry of H&FW. Two new departments, namely, Health Research and AIDS Control have been created during this period. The expenditure by the Department of H&FW in the first three years of the Plan under NRHM has been 95.32 per cent, 94.39 per cent and 96.04 per cent respectively of the funds allocated, whereas under non-NRHM it has been lower at 73.16 per cent, 82.42 per cent and 85.96 per cent respectively, the appraisal said.

Overall expenditure for the Department has been 90.55 per cent, 91.58 per cent and 93.60 per cent respectively in 2007-08, 2008-09 and 2009-10. Department of Ayush has been able to spend 78.39 per cent, 88.22 per cent and 92.64 per cent of the funds allocated for the respective years. As newer initiatives take time to become operational the initial fund utilisation is low, it said.

"Under NRHM, utilisation of funds by States has shown improvement but the situation is still not satisfactory. As per calculations based on MoHFW's data, utilisation of funds by all States increased from 59.03 per cent (2005-06) to 64.97 per cent (2008-09). In case of high focus States, the utilization level has increased from 56.35 per cent (2005-06) to 62.11 per cent (2008-09). In the non-high focus States; the increase is from 62.62 per cent to 69.23 per cent during the same period, indicating relatively higher utilization than in high focus States,'' the report said.

There is large amount of unspent balance with States under NRHM. Unspent amount of Rs 8,639.12 crore is lying with States against an amount of Rs 40,820.46 crore released during the period from 2005-06 to 2009-10 " This could be due to poor budget planning, further release by the States to the districts for which the expenditure has not been reported, poor absorptive capacity of the system and delays in execution of civil works. All such lacunae need to be examined in order to take corrective measures," it said.

"A determined effort needs to be made in the last two years of the Eleventh Plan to meet Plan targets. Most of the institutional arrangements under NRHM are in place but the processes required to achieve the outcomes need to be strengthened. Special efforts need to be made for the excluded/vulnerable areas and groups. Rather than mechanically establishing health facilities on the basis of population norms, there is need to re-visit these; as most of the neglected groups reside in far flung areas or are difficult to reach," as per the Planning Commission, while calling for an online monitoring system to make sure that unspent allocation is utilised well.